Fit for the future: 10 Year Health Plan for England

For the 10-year plan to succeed, it is absolutely paramount that all of the NHS, and its partners, engage fully and openly with councils across the country, and work collaboratively with us to deliver for our communities.

Health does not begin in hospitals – it begins in homes, streets, parks, and schools. The NHS cannot deliver a healthier society on its own. This is why we are urging ministers to set up a new national-local coalition to help deliver these neighbourhood health models that put prevention and place at the heart of public services.

LGA view

• The Local Government Association welcomes the NHS's 10-year plan and the clear and long-term vision it provides setting a defined direction for the future.
• We recognise the scale and urgency of the challenge and are committed to working collaboratively to achieve the three shifts. The NHS is one of local government’s most important partners and only by working together can we address the scale of change needed and in doing so improve outcomes and reduce health inequalities across our communities.
• Effective integration across the NHS and local government is essential to realise these ambitions. With significant change underway in both sectors, we must commit to ‘rewire together’ and not turn inward into silos.
• We welcome the shift in narrative for health and care: not local government services that ‘protect the NHS’, but that bring joy, value and purpose to our lives.
• An effective coalition between national and local politicians to integrate health and care services for local citizens could yield powerful results, including a system truly designed around the needs of individuals in local places.

LGA view

Neighbourhood Health Service 

• The LGA welcomes the new Neighbourhood Health Service and a commitment to working at a neighbourhood level. Local government will be critical in shaping and delivering on the ambitions of the new Neighbourhood Health Service, through neighbourhood teams, neighbourhood health centres and wider neighbourhood working. We understand the communities we serve – their strengths, needs and assets. We are uniquely placed to convene local partners such as health, VCSE partners, business, and education to drive this work forward, bringing resource, workforce and assets to natural communities.
• That said, neighbourhood working must be about more than co-locating services and buildings and about working with natural geographies to understand local strengths and needs. Joining up services at a hyper-local level to achieve a shared goal has been a feature of good integrated services and strong communities for many years.
• There is no one-size-fits-all model for what 'good' looks like; indeed, the whole ethos of neighbourhood is that what works in one area, might not work for others. Therefore, the LGA and local government are keen to work with Government, trailblazers and health partners at a local and national level on the launch of the National Neighbourhood Health Implementation Programme. We must be a key partner in designing and delivering tailored neighbourhood health models. Local government can support on understanding the shared traits of areas that are already working in this way and better understand the blockages that may be preventing scaling and sustaining of neighbourhood working.
• We are supportive of social care professionals taking on health activities in blended roles with lots of good examples already in existence, but there needs to be proper clinical oversight and staff renumerated appropriately from the correct source, i.e. councils should not be left with the bill. Social care staff must have equality of esteem alongside NHS colleagues, and must be valued as part of this partnership approach. 

Family Hubs and Start for Life services 

• The LGA welcomes the Government’s commitment to align Family Hubs expansion with Start for Life services, creating more seamless, joined-up support for families with young children. We are pleased to see Start for Life extended across the full conception-to-age-five range, including additional health visiting and speech and language support, and are keen to work with the Department of Health and Social Care (DHSC) and the Department for Education (DfE) to shape its development.
• We urge the Government to commit to extending Family Hubs to all councils and commit to providing long-term, sustainable and flexible funding for the programme, enabling local areas to plan effectively for the future and tailor services to meet the specific needs of their communities. 

Personalised care

• The LGA welcomes the commitment to person-centred care and to enabling people to co-design their own support. We recognise that people who draw on care and support, along with their loved ones, are best placed to understand what works for them and what stands in the way of more personalised care. Across adult social care and local government, there are many strong examples of co-production and co-design in practice. The LGA and local government would be keen to share these experiences and approaches with Government and health partners, as there is much that we can learn from one another.
• The commitment to enable vaccinations for babies and children as part of health visits provides an important opportunity for reform. Allowing health visitors to administer routine immunisations, particularly for vulnerable or at-risk children, could play a critical role in reducing health inequalities and ensuring more children are protected. However, several considerations must be addressed when developing this policy, including logistical arrangements, investment in workforce capacity and training, robust evaluation and quality assurance. The scheme should be piloted to test its effectiveness prior to rollout, seeking input from a broad range of partners to shape delivery. 

Mental health

• We welcome the emphasis on community mental health services and the shift towards 24/7 mental health neighbourhood working. This ambition must be supported with adequate resourcing. We are interested to see the learning and outcomes from the neighbourhood mental health centres that are currently being piloted.
• Local authorities have significant statutory and non-statutory responsibilities for community mental health. They employ the majority of Approved Mental Health Professionals who are responsible for undertaking duties under the Mental Health Act. Local authorities need to be involved in the development of the neighbourhood care models from the outset.
• To ensure that Mental Health Emergency Departments (MHEDs) achieve their objective, they need to be linked strongly with local authorities. Local authorities support many people with mental health needs in the community – they have a shared responsibility with health partners for Section 117 aftercare support for people discharged from mental health hospitals. They commission a range of community mental health services, often jointly with the NHS and from a range of local private and voluntary and community providers. Such services support people with mental health issues in the community and when leaving NHS hospitals.
• It is important to note that local government spending on adult mental health comes from the adult social care budget. The Adult Social Care Activity and Finance Report 2023/24 shows that mental health was identified as the ‘Primary Support Reason’ for people who needed care: a total of 12 per cent of spend. Increasing costs and demand in adult social care means budgeted net spend on adult social care increased by £3.7 billion (18.1 per cent) in real terms from 2019/20 to 2024/25. Despite the rate of inflation falling from its peak, there is little sign of these cost pressures tailing off. Of the additional £3.7 billion in budgeted spend since 2019/20, £1.9 billion of this increase was from 2023/24 to 2024/25.
• There is an urgent need to rebalance spending in favour of community-based mental health services, in preference to paying the higher financial and other costs associated with providing inpatient care in response to emergencies, which might have been avoidable had investments in prevention and early intervention been made. Although this has been the ambition of successive governments’ policies, not least since it should increase system-wide efficiency, it is likely to require an extended period during which net-spending increases enable the ‘double-running’ of inpatient beds, whilst new investment in community services ensures their effectiveness is fully established.

Unpaid carers

• We agree that it is essential to work closely with unpaid carers to support them to continue the essential work they do. Councils regularly engage with carers when undertaking an assessment or review of a person's needs. Effective support for carers requires long-term, sustainable funding for social care and the importance of preventative support – particularly identification of carers, which can be challenging. Sharing of information between partners is essential. 

Intermediate care and reablement

• The focus on intermediate care and reablement in local communities is welcomed, but it needs to be therapy led with an experienced mix of therapists, community health services and experienced social care staff where these multi-disciplinary teams work together with a person-centred approach. 

Adult social care

• Action to stabilise and reform adult social care services is urgent and cannot wait for the Casey Commission to report. A promising local government Community of Practice has been put in place to develop proactive prevention, which must be supported. Adult social care requires strong national leadership – it is a cornerstone of healthy communities, not a mechanism to free up hospital beds.
• The ambitions of the 10 Year Plan simply can’t be realised in full if we don’t have an adult social care system that is financially sustainable, funded to be properly preventative, and rooted in personalised care and support. Adult social care isn’t a problem to be fixed or a draining cost but an investment in all of us and all of our communities. It supports adults of all ages to live the lives they want to lead and it supports our economy to the tune of around £60 billion, much of which relates to the size and scale of the care workforce, which is bigger than the workforce of the NHS. The Government is committed to building a National Care Service, but that will inevitably take time, which is why we need to collectively work with the Casey Commission to help shape its recommendations on immediate actions. The Government needs to act on adult social care in the short- and medium-term, not wait until the Casey Commission issues its final report in 2028. Local government stands ready and willing to bring its unparalleled experience and expertise to the debate. 

Dentistry

• The LGA welcomes the Government’s plan to improve NHS dentistry, including its commitment to contract reform, better access and increased emphasis on prevention of poor oral health in children.
• LGA research shows no council in England has more than one NHS dentist per 1,000 residents, with rural and deprived areas hit hardest. We are pleased to see short-term action, including 700,000 additional urgent appointments and a new requirement for newly qualified dentists to work in the NHS for at least three years. However, this must be implemented fairly and with proper support for early-career professionals.
• We welcome the planned contract changes from 2026–27 to better reflect patient needs and we support the move toward a reformed system that prioritises prevention, workforce support and increasing equitable access.
• The focus on children’s oral health is vital. Expanding supervised toothbrushing and other interventions (such as fluoride varnish) and upskilling dental therapists and nurses could help reduce hospital admissions and improve outcomes. However, we are calling for an expansion of NHS dental care access and appointments for children to ensure they can access care when and where they need it.
• Embedding dental professionals in neighbourhood teams is a promising step toward integrated, community-based care. Councils are well placed to support this through their public health role.
• Tackling the root causes of poor oral health requires sustained investment in community-based oral health promotion programmes. Councils need a real-terms increase in the Public Health Grant to deliver these vital services to prevent long-term health problems.

LGA view

• The LGA welcomes the ambitious vision set out in the NHS 10-year plan to modernise the health service through digital transformation. The commitment to more accessible, patient-centred NHS care, supported by a fully integrated NHS app and Single Patient Record is a positive step towards improving care co-ordination and empowering individuals to manage their own health.
• However, as laid out in the State of Digital Government by the Department for Science, Innovation and Technology (DSIT) in early 2025, legacy systems, inconsistent data standards and limited interoperability across the public sector remain significant barriers. Overcoming them must be driven and underpinned by a consistent and enabling approach to information governance. Without a strategy to address these foundational issues, innovation risks being unevenly distributed. Local government must be an equal partner in shaping and delivering digital plans.

Single Patient Record

• The Single Patient Record (SPR) is a cornerstone of the NHS’s ambition to deliver integrated, person-centred care. However, to truly fulfil this vision, the SPR must be interoperable across the entire health and care system. At present, there remains a persistent issue with the narrow framing of who can access these records and what information is considered relevant. As a minimum, the SPR should include information from the NHS and social care.
• A more holistic approach is also needed, one that reflects the broader determinants of health, such as housing and benefits. This shift also calls for a change in perspective, moving from the concept of a 'patient' and towards a 'person', thereby recognising the SPR as the basis of a Single Person Record.
• Past attempts to create national care records have faltered due to broad scopes, lack of clarity around their intended use and insufficient budget for all stakeholders to benefit. To avoid repeating these mistakes, SPR development must be co-produced with a wide range of stakeholders, including people who draw on services, the NHS, local and central government, private companies, and the voluntary and community sector.
• There are successful regional models that can inform this work, such as the London Care Record and Connecting Care in the South West, and practical learning available from the Shared Care Record Local Government Network.
• Currently, data and information governance and standards are applied inconsistently across different parts of the system. A unified approach is essential, one that aims for a single, shared dataset to provide a consistent and accurate view of each person’s health and care journey. Rather than introducing new data collection burdens, efforts should focus on improving and linking existing datasets.

NHS App

• The NHS App should serve as a shared digital platform that supports not only patients but also professionals across adult social care, public health, and local government. Current limitations in access for these sectors hinder coordinated care and self-management.
• The ambition to make the NHS App the front door for both health and social care services must be aligned with other digital initiatives like the national online front door for adult social care, OneLogin and early thinking around a National Care Service to avoid duplication and ensure a seamless experience for people.
• Accessing the NHS App remains difficult for many, with nearly 40 per cent of UK adults still unregistered, and changes introduced recently made the app incompatible with older devices. To avoid deepening digital inequalities, the rollout of the app must be closely coordinated with local government and frontline services, who are best placed to understand and address local barriers and support residents with complex needs. Without their involvement, national digital tools risk reinforcing existing disparities rather than closing them.

Artificial intelligence (AI) and digital innovation

• The high level of aspiration for AI and other data and digital technologies to achieve both efficiencies and personalised outcomes within the 10-year vision is welcome. There is considerable scope for joint innovation across health and care by harnessing both consumer and specialist technologies to support independent living and wellbeing, enabling the shifts to community and prevention of illness from hospital and treatment of sickness.
• However, it is vital that the transition to this future is managed ethically, safely and responsibly, working in partnership with people and partners. Building this future successfully requires investing in smart foundations first. This is needed to tackle current issues caused by fragmented, legacy technology and wider infrastructural challenges including skills.
• Putting people at the centre of digital transformation requires early investment in technologies like AI and strong collaboration between the NHS, local government, care providers, and the voluntary sector recognising each partner's role and strengths. 

Workforce and capacity building

• In all parts of the health and care system, digital leadership is often not considered a priority at an executive level. This limits the ability of public institutions to implement tech-enabled programmes in cross-cutting services. Social workers, occupational therapists and other allied professionals need a national workforce programme or strategy to support growing digital data and technology skills and ensure parity with NHS workers. It is crucial that investment is made to equip public sector workforces with the necessary skills and knowledge to manage and use digital technology, in particular AI, effectively. 

LGA view

Creating a smoke-free generation

• Councils play a crucial role in tackling smoking through a combination of policies, enforcement, education, and support programs. The LGA supports the Government's introduction of the Tobacco and Vapes Bill – a landmark initiative aimed at protecting future generations. The proposals offer a comprehensive approach, including support to help smokers quit, measures to prevent young people from starting, and actions to address concerns related to vaping.

Tackling harmful alcohol consumption

• Alcohol-related harm remains a serious public health concern in England, with the most acute effects often concentrated in more deprived communities. Local authorities continue to face mounting pressures on health services, social care, policing, and community safety as a result of alcohol use.
• The LGA has long championed the introduction of a fifth licensing objective focused on protecting public health, to sit alongside the existing four objectives under the Licensing Act 2003. We are disappointed that the Government has decided not to move forward with this important reform. A public health objective would have given councils the ability to consider the broader health impacts of alcohol when making licensing decisions, particularly vital in areas experiencing high levels of alcohol-related harm, where current legislation offers limited grounds to act on health concerns alone.
• We support the Government’s intention to consult on alcohol labelling, including proposals to ensure that health warnings, nutritional information, and other key details are clearly displayed on packaging. We also support efforts to grow the no- and low-alcohol sector as part of a wider harm approach.

Obesity

• We welcome the new healthy food standard and mandatory reporting on healthy food sales as key steps toward better public health and industry accountability. Councils are well placed to support implementation through public health teams and local partnerships. Small retailers must be supported to help make healthy choices easier for all.
• We support existing proposals to strengthen the Soft Drinks Industry Levy to further drive reformulation, including ending the exemption for milk-based drinks and reducing the minimum sugar thresholds.
• We support the decision to update school food standards legislation, to ensure all schools provide healthy, nutritious food.
• We welcome the 10 per cent uplift to the Healthy Start scheme and continue to call for its extension to all Universal Credit recipients with children up to age five, bridging the gap before Free School Meals (FSM) eligibility.
• We support the expansion of FSM from 2026 but urge national auto-enrolment to ensure no eligible child misses out on a nutritious meal or related benefits.

Air quality

• We welcome the Government’s recognition of air pollution as a major public health issue and its associated commitments to improving air quality.
• In particular, we support the investment in active travel infrastructure alongside capability-building support and collaboration with Active Travel England.
• We note the planned review of the Environmental Improvement Plan and forthcoming consultation on domestic burning, and support strengthened work with the health sector to raise awareness of air pollution’s health impacts.
• Proposals to improve housing conditions, particularly addressing damp and mould, and the development of a new Warm Homes Plan and Fuel Poverty Strategy are also welcome.
• Councils are committed to reducing harmful emissions and many have already developed or implemented local air-quality action plans. However, success will depend on sustained funding and the devolution of appropriate powers to enable councils to enforce and deliver meaningful improvements in air quality.

  Health incentive schemes 

• The LGA supports the Government’s interest in incentivising healthier behaviours but urges a cautious, evidence-based approach. We welcome the evaluation of the Wolverhampton pilot to understand what works, for whom, and the contexts.
• Any national scheme, such as the proposed NHS digital points system, must be co-designed with local government to ensure it meets local needs, integrates with public health services, and reduces health inequalities.
• Financial incentives – ranging from cash and vouchers to prize draws – have been used to encourage behaviours like quitting smoking, attending health appointments and increasing physical activity. These programmes must be voluntary, inclusive and evaluated for long-term impact. They should also address digital exclusion by offering accessible, offline options.
• We look forward to engaging in the upcoming market engagement process and continuing collaboration with Government to promote healthier, more active communities.

HIV Action Plan

• We welcome the introduction of a new HIV Action Plan. Ending new HIV transmissions by 2030 is an ambitious but achievable goal. This must be a catalyst for real change, embedding HIV prevention, testing, and care across every level of the health and care system.
• We are concerned by the absence of any reference to sexual and reproductive health in the plan. This omission represents a significant missed opportunity to address one of the most fundamental aspects of public health and personal wellbeing. Without strategic investment and integration into long-term planning, we risk widening health inequalities and undermining public health outcomes. 

Vaccines and boosting uptake of childhood immunisations

• Vaccines are vital to public health, and the LGA supports efforts to boost uptake, including enabling greater access to HPV vaccinations to help eliminate cervical cancer by 2040. Restoring childhood immunisation rates will require more than improved access: tackling vaccine hesitancy is key.
• We want to see greater investment in trusted voices, such as health visitors and school nurses, and for Government campaigns to be locally informed and community-led. Councils are well placed to work with families, educational settings and community groups to build trust and ensure no one is left behind.

Genomic screening

• While councils do not have a direct role in delivering genomic screening, local government will play a vital supportive, representative and enabling role.
• As genomics increasingly informs disease prevention and early detection, councils will need to become key partners in cross-sector collaboration, helping ensure that genomic advances translate into equitable health outcomes for their communities. As genomic data becomes more central to healthcare, the residents that councils represent may have concerns about privacy, consent, and data use. Local government has a crucial role in fostering public trust, ensuring that communication is clear, inclusive, and responsive to local needs.
• Genomic screening also raises complex ethical questions – not just clinical, but societal. It is essential that Government and NHS England actively engage local government, so that screening programmes reflect the values, priorities, and diversity of the communities they serve. 

Employment and good work

• The LGA supports the 10 Year NHS Plan’s strong focus on the vital link between good work and good health. We are pleased to see recognition that poor health is a growing barrier to employment and that early, integrated support is essential to keeping people in work.
• Local government plays a crucial role in supporting people’s health, skills, and employment prospects. We particularly welcome the commitment to closer collaboration between ICBs, councils, and other local partners to deliver joined-up services that reflect the needs of communities.
• As alluded to in the plan, there are various interventions or services in this space such as Connect to Work, Work Well, Health and Growth Accelerators, Individual Placement and Support, and proposals for Neighbourhood Health Centres to provide employment support, alongside major reform of the JobCentre Plus network. While this makes for a complicated system on the ground, it should be an opportunity for local partners to work innovatively to use local resources, e.g. employment specialists, effectively. Coordination and alignment across a place is therefore critical, especially as the Spending Review 2025 secured increases in employment support funding.
• Local government – councils and mayoral strategic authorities – are now responsible for leading the development of local Get Britain Working (GBW) plans. As part of this role, they will engage local partners – including job centres, ICBs and other partners – map what is happening locally across the local employment, health and skills landscape, and determine what priority actions are needed to address issues like economic inactivity.
• Local GBW plans are an important first step to bringing coherence to the local landscape and we welcome this approach. As these develop with time, they should evolve into multi-year agreements with budgets and outcomes attached. We are calling for a new Local Labour Market Fund combining support for local employability, skills and health initiatives to replace the relevant parts of the UK Shared Prosperity Fund. We are keen to work with Government on this, and to co-design various GBW reforms such as the new Jobs and Skills Service. 

Thriving young lives 

• We welcome the plan’s strong focus on children and young people’s mental health, including those with SEND. Key commitments include full rollout of mental health support teams in schools and colleges by 2029–30, Young Futures Hubs, and a ‘no-wrong-front-door’ approach to support.
• The commitment to recruit 8,500 mental health staff and improving care for children with complex needs in residential settings addresses long-standing access issues, helping reduce hospital admissions and emergency visits.
• We support the emphasis on early intervention through joint working across education, health, and local services. Reforms aim to deploy allied health professionals more effectively, reducing admin and increasing direct support.
• We also back the expansion of mental health support teams in schools and call for a cross-government plan for children, including a dedicated mental health Tsar to drive accountability. However, we were concerned not to see school nurses mentioned at any point in the plan, especially given their vital role supporting children’s health and wellbeing.
• On SEND, we know that the current system is in crisis – failing too many children and threatening the financial sustainability of councils. We welcome the plan’s focus on early intervention and greater mainstream inclusion, both of which must be central to meaningful SEND reform.
• We support plans for a single unique identifier (SUI) for every child to enable joined-up care, but stress it isn’t a ‘magic bullet’ and must be backed by investment, admin support, and clear guidance to be effective.

Physical activity

• We welcome the commitment to a place-based approach to physical activity. However, the initiatives and funding referenced are already in progress. It’s vital that the £400m investment in community sports facilities is guided by existing evidence and tailored to local needs, rather than a one-size-fits-all approach. It will be important to connect these effectively into health systems to ensure maximum impact and minimising the need for costly medical interventions.
• While the focus on increasing activity levels is positive, there are already well-established campaigns like We Are Undefeatable and This Girl Can. Any new campaign should build on these, using local insights and addressing intersectionality to effectively tackle barriers to participation.
• Current data, such as the Active Lives Survey, lacks sufficient local detail and excludes key groups like care-experienced children. Improved data and a better understanding of the multiple barriers faced by the least active groups are essential to designing effective, targeted interventions. 

LGA view

Local accountability

• We have long argued the need to let local leaders lead and the need for space and flexibility to allow local leaders to innovate and focus on the priorities that are most important to local communities, and the importance of local accountability to local citizens.
• Local government plays a vital role in local democratic accountability for our residents. We look forward to working with Government to further consider democratic oversight and accountability in light of the new NHS operating model, the role of mayors and reforms to local government.

Integration

• Funding flows need to support intermediate care as key to the community shift. The Better Care Fund requires reform, with a firmer footing for integration funding to avoid costly crisis interventions. Investment must focus on building basic infrastructure with long-term certainty avoiding the distraction of high-profile, small-scale schemes.
• Good integration happens in places with good system leaders, who recognise the importance of collaboration, and invest time and energy into creating a shared vision and response. Good governance and ways of working help, but without a recognition of the vital contribution of collaborate system leaders, it can all too often fail to meet its ambitions.
• There is a risk that as ICBs grow to cover much larger populations, it may negatively impact on their ability to commission well at a very local neighbourhood level and reflect local needs. Local government has an important role to play in championing the needs of their communities. 

Boundary changes

• We welcome the Government's commitment to further devolution through the 10 Year Plan, and the intention to align ICB and strategic authority geographies. Co-terminosity of public services offers the chance to increase local democratic accountability and bring greater coherence to the governance of key public services such as health, transport, skills, economic development and planning.
• However, while coterminous public service boundaries have the potential to deliver significant benefits, the current piecemeal process of reform risks leaving some areas stuck with an indefinite period of misalignment.
• ICBs are already starting to cluster for financial reasons, with a tight national timeline to do so. These clusters are unlikely to match emerging or future strategic authority boundaries and this risks a second wave of clustering, a resource-intensive and time-consuming exercise.
• To help mitigate this uncertainty, the Government should produce a transparent timeline for devolution beyond the Devolution Priority Programme Areas. This timeline should form the framework for NHS and other public sector reform including police reform, to ensure a coordinated approach across the public sector where co-terminosity of services and alignment of geographies is the ambition.
• Government must also adequately resource ICBs in the interim to enable this alignment to strategic authority geographies over time.

ICB membership

• Removal of local authority representatives from ICBs is a step backwards from a joined-up and localised approach to health services, given councils are at the forefront of both local and neighbourhood service delivery. Additionally, this risks leaving behind those areas that do not currently have a strategic authority in place. Local government should continue to be represented on ICBs, alongside mayors, to enable join-up between strategic, local and neighbourhood planning and delivery. Inclusive growth cannot happen without local government.

Total place

• We welcome the Government's intention to empower places to partner on pooled public spending approaches to prevention. Our report Trusting place: Improving the lives of local people through place-based approaches advocates for a liberated culture and leadership across local public services, with iterative approaches that accommodate local needs and allow for experimentation. It is important that this new opportunity is truly place-based, service-user centred, giving local places the power and permissions to experiment and act differently.
• This must involve a duty to collaborate with local government, a limited mandate from central government, and a 'whole place' view by regulators to focus on learning and reward collaboration and innovation.     
• The LGA is ready to work with government to ensure this works for the sector and places.

Health and Wellbeing Boards

• Health and Wellbeing Boards are powerful engines of local change – strategic conveners that bring together system leaders to improve the health and wellbeing of their communities. In an era of growing health inequalities and system pressures, HWBs are more than advisory bodies: they are strategic conveners and catalysts for change. Their power lies in partnership: aligning resources, breaking down silos, and driving collaborative action across sectors. As the health and care landscape evolves, HWBs remain essential to delivering sustainable, equitable, and community-led solutions.
• We welcome a continued role for Health and Wellbeing Boards to drive forward joined-up approaches to local health services for communities and residents. The LGA calls for coordination with the Government's intention to bring in neighbourhood area committees for all local areas in the forthcoming English Devolution and Community Empowerment Bill to ensure representation from the health and care sector.

Public health 

• As local authorities continue to lead the delivery of public health services in England, we welcome the importance of peer review as a tool for improvement, accountability, and innovation. Peer review offers a constructive, collaborative approach to strengthening public health outcomes. We endorse the commitment that every single public health authority participates in an external public health peer review. The LGA is best placed, as part of its sector-led improvement offer, to lead this work. This must be accompanied with strengthened investment in sector-led improvement, enabling councils to share best practice and drive continuous improvement.
• The LGA have consistently called for a long-term sustainable funding plan for public health to ensure that local authorities can plan services effectively and meet the needs of their communities. We continue to emphasise the importance of investing in prevention, arguing that a well-funded public health system can help bridge health inequalities, reduce NHS and social care pressures, and improve overall population health. Despite these calls, public health funding has faced a decade of cuts, with spending per person significantly lower than a decade ago. The Spending Review 2025 made no new commitment to public health and to ensure that funding keeps pace with rising demand and inflationary pressures. The LGA has highlighted significant cuts to the public health grant, with real-terms reductions of £858 million between 2015 and 2024. This has led to a reduction in councils' ability to fund public health services and a greater focus on statutory obligations, potentially impacting preventative services.
• The capacity to commission effectively – particularly in areas such as sexual health, drug treatment and health visiting – has been constrained by a decade of funding pressures and increasing complexity in the health system.  The LGA would welcome additional support in exploring how DHSC might provide targeted commissioning support to local public health teams, including access to technical commissioning expertise and data analytics.

LGA view

• Local Healthwatch plays a vital role in advocating for and improving health and social care services and compliments existing citizen engagement work led by health and local government. It acts as an independent champion for the public, ensuring that their experiences and feedback are heard by decision-makers and also supports citizens in navigating, what can be a complex system. It is vital that both the split in roles across ICBs and local authorities does not dilute this important role. The LGA offers to work closely with local authorities, ICBs and the NHS Confederation to support the effective transfer of this important function.
• It is essential that the Modern Service Frameworks are developed in partnership with local authorities and reflect the role and responsibilities of councils in supporting people with mental health needs or dementia in the community. It is worth noting that the previous National Service Frameworks were for both health and social care.

LGA view

• It's not just the interdependencies between our health and care systems that matter; it's their respective workforces, too. The forthcoming workforce strategy for health sounds laudable, but if there isn't an equivalent strategy for the care workforce, we risk deepening the concerns that there is a fundamental lack of parity of esteem between the people delivering our health and care services. The Skills for Care long-term strategy is an excellent starting point, having been coproduced with and for the sector, and should form the basis of the Government's thinking.
• Central government must commit to funding the output of the Adult Social Care Negotiating Body (ASCNB) and Fair Pay Agreement (FPA) process, and local government must be an integral part of the negotiating body and FPA design process to ensure FPAs are workable and can deliver government’s intention.

LGA view

• Digital and Data Infrastructure: The health and care system struggles with fragmented data which is spread across numerous systems with inconsistent information governance. Different trusts, ICB boards and local councils have different data collection methodologies, and storage on different software and governance processes which make it difficult to enhance data interoperability, inhibiting monitoring and improvements of health and care services. Also, currently, many local authorities get very little data insight at the local authority geography of interactions between their local populations, hospitals, Trusts and primary care. This leaves a significant gap in the intelligence needed to design effective local integrated services and needs to be urgently addressed. As previously mentioned it is vital that local government and the intersection of health and care with all council services  (including housing, schools and leisure) are considered in the design of data sharing standards, laid out in the new Data Use and Access Bill and there are also several general principles of data and digital services that we recommend are applied at all service levels to ensure data is shared and governed effectively and to the same standard: 
   
  
  • All partners need to have access to digital and data systems – including local authorities and the community and voluntary sector.
  • As far as possible, aim for a single data set, accessed and used by all, so that all partners have a single version of the truth.
  • Maximise the use of existing data sets rather than creating new data collection and reporting burdens.
  • Be clear about the purpose of data reporting and collection – what problem are you aiming to solve by collecting this data?
  • Be clear about the benefits and costs of collecting data, collating it at system, regional and national level.
• Incidences of technological innovation in health and care services are happening at a local and national level; however, this work is limited by scalability beyond proof of concept, single services or areas of care. To support greater scalability of SME-based solutions and to disrupt legacy markets, the healthcare system needs to support SME suppliers and needs to invest itself in cloud-based platforms to enhance data sharing, invest long-term in digital migrations and upskill the workforce to support scalable solutions. To scale innovation, local systems also need to proactively create communities of good practice between different organisations in the health and care system.
• There is a vital need to ensure digital access and literacy for residents, especially in underserved communities, to avoid widening health inequalities as digital tools expand.
• AI: It is crucial that investment is made to equip public sector workforces with the necessary skills and knowledge to manage and utilise digital technology, in particular AI, effectively. This includes skills to be able to evaluate the ethical and privacy considerations to effectively implement and challenge the AI.
• Global Institutes and Regional Health Innovation Zones: Local government plays a vital role in place-shaping and attracting investment into communities, such as adopting supporting infrastructure and bespoke business support. This role should be recognised by Government and local authorities and their associations should undertake a valuable partnership role – alongside Mayors – as experienced innovators, in both Global Institutes and Regional Health Innovation Zones.

LGA view

• We acknowledge the importance of aligning NHS funding more closely with actual health needs across the country. Adjusting funding formulas to better reflect local health inequalities and socioeconomic factors may help address regional disparities in care. Providing additional support to areas facing greater health challenges could contribute to improved outcomes and a more balanced distribution of resources. We also recognise that such changes involve trade-offs, and it is important to carefully consider the potential impact on all communities to ensure a fair and transparent transition.
• We welcome the shift to a more outcomes-based approach to financial management. Our members continue to share examples of how the financial strain on the NHS is severely hindering councils’ ability to deliver essential services especially in relation to continuing healthcare, SEND and complex care packages. Cost shunting behaviours create significant local tensions and distraction but have no net benefit to the public purse. Transferring underfunded statutory functions will not improve services